What was supposed to be the world's most technologically advanced hospital sits today off U.S. 280 a shell. One million square feet of space. Thirteen vacant, mostly unfinished floors. Four hundred million dollars worth of concrete, glass, steel and hardware.

But if officials with Trinity Medical Center win the approval of the state Certificate of Need Review Board on Wednesday, Richard Scrushy's dream of a "digital hospital" could be realized within as little as two years.

Officials with Trinity, property owner Daniel Corp. and the construction firm Brasfield & Gorrie said last week that even after five years in mothballs, the building is in remarkably good shape.

"It's essentially a shell building ready to be built out," said Jason Lee, project manager for Brasfield & Gorrie.

Though just four floors have been completed, the building is 60 to 65 percent finished, he said. The finished floors stand ready for medical equipment to be plugged in and for beds to be wheeled in to patient rooms.

The other nine floors are vast caverns of concrete, still needing interior walls, plumbing and wiring.

Trinity wants to spend $280 million to complete the building, and vacate its east Birmingham campus. It first won approval to build a new hospital in Irondale, but later elected to pursue the partially-completed U.S. 280 building instead. HealthSouth Corp. had been building the hospital, but construction was halted two years after its $2.6 billion accounting scandal came to light in 2003.

Trinity, which has the option to buy the incomplete building for $40 million should the certificate of need be approved, could save $94 million compared to the cost of all-new construction in Irondale, officials said.

Opposition

Trinity's pursuit of the U.S. 280 hospital has faced stiff opposition. Community activists in Crestwood have argued that if Trinity vacates its current campus neighborhood property values will suffer, and it will be difficult to redevelop the property. Others have argued that the hospital will worsen the already snarled U.S. 280 traffic, and that ambulances may end up stuck in traffic jams.

And Brookwood Medical Center has argued that a Trinity hospital on U.S. 280 would provide unfair competition.

After the longest certificate of need hearing ever held in Alabama -- a six-week affair including 8,000 pages of testimony from 61 witnesses -- Administrative Law Judge James Hampton last month found that Brookwood would suffer "significant financial stress" and lose up to $17 million a year in business should Trinity complete the facility.

But Hampton recommended that the certificate of need board approve Trinity's plan, saying it serves the community overall. And the project has received the blessing of Gov. Bob Riley.

Should the board approve the plan, Brookwood and other parties would have the right to appeal to the courts. Efforts to reach Brookwood officials for comment were not successful. Should the board reject the plan, Trinity likely would appeal.

In a walk-through of the building last week, Granger, Lee and officials with Daniel Corp. said that the building represents too good an opportunity to pass up.

Layout

Scrushy, now in prison in Texas serving a six-year sentence for bribing former Gov. Don Siegelman, set out to build the most technologically advanced hospital in the world. Even after sitting unfinished for five years, the building still is cutting-edge for a hospital, they said.

"There was zero value analysis (under Scrushy)," said Lee, who managed construction under the former HealthSouth boss. "No corners were cut."

Visitors walk into a mammoth lobby with high ceilings and a glass wall that extends the length of the building. Family members accustomed to getting lost while navigating the halls of hospitals will ride up a single bank of elevators, and have to make only a couple of turns to find their destination.

"The vertical configuration makes the flow much better," Granger said.

Intensive care units are consolidated on a single floor, where nurses can work at desks that allow them to watch two patients simultaneously, without entering their rooms. There are lots of small touches easily lost on those who don't work in health care:

ICU rooms include toilets, giving patients a measure of dignity if they are mobile enough to use them, and providing caregivers a convenient and sanitary way to dispose of waste if they are not.

Operating room equipment will be suspended from the ceiling, making it easier to keep the rooms sterile.

Nursing stations -- four on each floor -- are located directly above and below one another in a layout that is identical on every floor. Nurses will be able to use a decidedly old school device, pneumatic tubes, to send lab samples between floors.

Rooms are designed so that the heads of beds will be visible from the hallway when doors are open.

Three truck-sized generators on the ground floor will provide 30 days' backup power using just the fuel on hand.

There are other design features that reflect Scrushy's penchant for spending whatever it takes to have the best. Rooms are about a third larger than typical hospital rooms, except for suites, which include a second room for family or visitors. Every patient room is a single-occupancy room, and rooms all will have dramatic views of the Cahaba River valley. Doors are hung on piano hinges to make them more durable.

HealthSouth and now Daniel Corp. have spent $1.5 million a year for the last five years to keep the building's air conditioning and heating systems running to make sure it didn't suffer damage from heat, cold and humidity.

"It's been a big investment," said Colin Luke, an attorney representing Trinity.

The development, should the plan be approved, probably won't stop with the hospital. Daniel Corp., which owns the building and the surrounding property, intends to build a four-star hotel adjacent to the HealthSouth conference center. The hospital would be the flagship for Trinity's parent company, Tennessee-based Community Health Systems, so the conference center would be a natural for medical conferences, said Jim Adams, senior vice president at Daniel Corp.

Plans also call for a medical offices building and retail development and a lower-tier hotel nearer the front of the property.

While waiting for the board's decision, Trinity officials already are making use of the building, Granger said. They bring job recruits to the facility to show it off and let them marvel at the views. So far, Granger said, the building has helped land physicians including a cardiologist from Harvard.